Global computerization and technological advancements in medicine and integration with medical equipment have enabled the healthcare industry to manage patient records in a more productive and organized way, principally by utilizing any one of a number of electronic health record (EHR) systems that are commercially available. Many EHR systems provide specialized workflows and enhanced functionality for healthcare professionals but often these systems are stand-alone and cannot exchange information across multiple locations or multiple systems. Patients visiting multiple medical facilities cannot fully benefit because these EHR systems do not have any way to locate or exchange medical data between systems or between two instances of the same system.
This fragmented nature of medical records can make it difficult for patients and healthcare professionals to obtain a full, consistent, and complete medical history (i.e. a longitudinal medical record) in order to provide the best care. Without the ability to share records, healthcare costs increase when diagnostic and laboratory tests are duplicated at another facility because they do not have access to results from the previous institution. A nationwide health information exchange with secure and quick sharing of data between stakeholders and systems, and between platforms, is needed in order to have an effective public health system. A complete longitudinal health record for all patients can be achieved with a functional nationwide health information exchange.
Health information exchange (HIE) platforms are being developed using existing methods of data interchange and standardized formats like those developed by HL7 (Health Level Seven International) and DICOM (Digital Imaging and Communications in Medicine). These existing platforms require centralized or common data storage (e.g. Microsoft® HealthVault™), or agreements that allow provider organizations to mutually sign-on to each other's systems. Standards harmonization must occur between each stakeholder and the nationwide health information network (NHIN) in order to create a nationwide health information exchange. The persistent issue in these approaches is the uncertainty that the record set to be accessed with some type of operation (e.g., create, read, update, or delete operation (CRUD)) is actually the most current and complete record set. Given that the data is “live” in multiple systems and concurrent operation actions are likely, the healthcare provider may not be working with the most up to date data. With current approaches to data interchange, healthcare providers can't be sure. Clearly, there is a need to reliably locate and easily, but securely, share electronic health records across multiple medical facilities with assurance the record set retrieved is the last updated and most comprehensive.
Therefore, there exists ample opportunity for improvement in technologies related to sharing electronic health records.